<extend name="Public:common" />
<block name="content">
    <!--/sidebar-->
    <div class="main-wrap">

        <div class="crumb-wrap">
            <div class="crumb-list"><i class="icon-font"></i><a href="/Admin">首页</a><span class="crumb-step">&gt;</span><a class="crumb-name" href="__URL__/index">银行卡管理</a><span class="crumb-step">&gt;</span><span>新增</span></div>
        </div>
        <div class="result-wrap">
            <div class="result-content">
                <form action="__URL__/insert" method="post" id="myform" name="myform" enctype="multipart/form-data">
                    <table class="insert-tab" width="100%">
                        <tbody>
                         <tr>
                            <th width="120"><i class="require-red">*</i>收款人：</th>
                            <td>
                                <input class="common-text required"  required name="received"  size="50" value="" type="text">
                            </td>
                        </tr>
                        <tr>
                            <th width="120"><i class="require-red">*</i>收款人账号：</th>
                            <td>
                                <input class="common-text required" required name="card"  size="50" value="" type="text">
                            </td>
                        </tr>
                            <tr>
                                <th><i class="require-red">*</i>开户行：</th>
                                <td>
                                    <input class="common-text required" id="title"  required name="startadd" size="50" value="" type="text">
                                </td>
                            </tr>
                            <tr>
                                <th>状态：</th>
                                <td>
                                <select name="status" id="catid" required>
                                    <option value="">请选择</option>
                                    <option value="1">开启</option>
                                    <option value="0">冻结</option>
                                </select>
                                </td>
                            </tr>
                            <tr>
                                <th></th>
                                <td>
                                    <input class="btn btn-primary btn6 mr10" value="提交" type="submit">
                                    <input class="btn btn6" onclick="history.go(-1)" value="返回" type="button">
                                </td>
                            </tr>
                        </tbody></table>
                </form>
            </div>
        </div>

    </div>
    <!--/main-->
    <script>
        function dian() {
            $("#form").submit();
        }
    </script>
</block>